Posts Tagged ‘Chris Hipkins’

The National Government has no plans to merge local authorities in the Hutt Valley, local list MP Paul Quinn (National) says.

He was responding to Rimutaka MP Chris Hipkins (Labour)(see previous post), who had said the way the legislation had been rushed through parliament for Aucklands “Super City” set a dangerous precedent for local government reform in other parts of the country “including here in the Hutt Valley”

Mr Quinn goes on to say “I stated at a public meeting (last) October that there was plenty of scope for the Greater Wellington Regional Council to sharpen up its act. I also made it clear that a merger was something for the communities of Upper Hutt and Lower Hutt to decide”

All credit to Mr Quinn, and also his stated stance at Project Awakairangi (Hutt Valley Police Merger) meetings that he attended and was upset that the police had adopted the project without consultation.

No doubt this issue wont go away given the profile of Aucklands Super City.

It is important to note that in late April, Local Goverment Minister Rodney Hide met the Hutt Valleys 2 mayors.

Mr Hipkins asked Mr Hide in Parliament whether he had received any advice on the possibility of a merger in the Hutt Valley and was told Mr Hide had been given a memo and background notes prior to his meeting the 2 mayors. Mr Hide said the memo advised him the 2 mayors did not support amalgamation of all the councils in the Wellington region, “believing this process should be left to ratepayers to initiate” and that “Mr Ogden (Lower Hutt Mayor) had raised the idea of a smaller amalgamation between Hutt and Upper Hutt City Councils”

Mr Hipkin has since lodged an Official Information Request for a copy of the full memo and background notes.

HuttNZ is very interested in the context of this memo as well, the quote is worth a second look

“Mr Ogden (Lower Hutt Mayor) had raised the idea of a smaller amalgamation between Hutt and Upper Hutt City Councils”

We await release on this memo to find some conclusions, and give a clearer insight intothe mandate Mr Ogden appears to have adopted.

We believe that it is not up to council to decide but the public of the Hutt Valley. No doubt previous councils eg Eastbourne, Petone have opinions on mergers and the impact it has on community issues.

Whatever occurs, it is HuttNZ opinion that the public has a right to full disclosure on this issue, sooner rather than later.

Extracted from Chris Hipkins (Rimutaka Labour MP) blog it takes a strong stance on attitude to Super City legislation (no doubt partially fuelled from being in opposition) and the impact it could have on the Hutt Valley (are we next in line?) . It appears fairly obviously that the agenda around local government is moving, and fast.

I think it is important that we clearly think about the road ahead if this was to occur. Given strong feeling against police merger what does the Hutt Valley feel around this? I would appreciate your comments.

“Fundamentally I objected to the Super City legislation being pushed through parliament under Urgency because the people of Auckland haven’t had their chance to have a say on it. I think any reform as significant and extensive as the Auckland Super City proposal needs to be endorsed by a referendum,” Chris Hipkins said.

“While the government don’t seem to have immediate plans to replicate the Super City concept anywhere else, I am still concerned that many within National see the merger of the two Hutt Valley councils as inevitable.

“Before I support any reform of local government in the Hutt Valley I would need to be convinced that local people want it. From the feedback I’ve had so far, I sense there is a strong desire to keep our two local councils separate,” Chris Hipkins said.

Mr Hipkins said he had asked Local Government Minister Rodney Hide whether he had received any advice on the possible merger of the two Hutt councils and he confirmed that he had received some background information ahead of meetings he had recently with local mayors Wayne Guppy and David Ogden. Mr Hipkins has requested a copy of that information under the Official Information Act.

“While Rodney Hide claims a local government amalgamation in the Hutt Valley is not currently part of his plans, I’m still not convinced it won’t make it onto the government’s agenda in the near future.

“If they follow the same process they did with Auckland, our two councils could be merged, either with each other or as part of a wider Wellington council amalgamation and local people wouldn’t have a chance to have their say. That’s something I would actively oppose” Chris Hipkins said.

Mr Hipkins said the strong opposition to the proposed merger of the Upper Hutt and Lower Hutt police districts showed that Upper Hutt people in particular have a genuine desire to maintain a separate identity.

“Local government is about local communities. In my view central government shouldn’t go tampering with that unless they have a mandate from the people affected.

It’s well known that the Hutt Valley has a GP shortage but Dr Liz Fitzmaurice is convinced initiatives being taken now to tackle that will pay dividends well into the future.

The Hutt Valley District Health Board appointed Dr Fitzmaurice, who has worked as a GP for 20 years, to drive initiatives to improve liaison between primary and secondary health care.

The problem that hit the headlines last year is that we have one of the worst ratios of GPs per head of population of any urban area in New Zealand. Overwhelmed practices were unable to enrol new patients. It was estimated that around 3,000 people couldn’t enrol with a GP in the Hutt Valley.

A pilot project run by the DHB over summer found that an average of three people a day attending Hutt Hospital’s Emergency Department were not enrolled with a GP.

A centralised ‘Access Co-ordination Service’ has been established. Instead of people who have moved to the Hutt having to phone around all the different practices to find a GP, now there is a single phone number (570-9462). The service, fronted by Joanne Doherty, liaises with practices and can offer advice to people about where it’s worth trying to enrol or go on waiting lists. If there is an urgent medical situation, care will be arranged.

At last week’s DHB meeting, chairman Peter Glensor said it is misleading to describe local GP practices as “closing their books” to new patients. “They’re managing their registers; that’s a more accurate way to describe it. When someone goes off their list they’re putting others back on but they’re using waiting lists to do it.”
He is encouraging people without a GP to register with the DHB’s access service.

Dr Fitzmaurice says the number of people not registered with a GP is “fluid.

“Since November, we have been starting to centralise a process. We have someone phoning those patients and some of those early ones who came on (to our register) are now with GPs.”

But she stresses that the problem is not solved.

“I don’t want people to think there are enough GPs in the district now, because there aren’t. This service isn’t about ‘you ring me, and I’ll find you a GP today.”

The service is about co-ordinating a process to manage the shortage and to ensure if the medical situation is urgent, care is arranged at the Emergency Department or the After Hours medical centres in Lower Hutt or Upper Hutt.

“We do get people telling us ‘but I rang that practice a month ago’. We encourage them to see it is worth ringing back and joining the waiting list. Just the other day there was a call from someone in that situation to tell us, ‘you’re right, I’m in’.”

Dr Fitzmaurice says everyone involved with primary care in the Hutt Valley is working to overcome the access issue, including the general practices and Primary Health Organisations.

She is involved with a number of initiatives to attract more GPs to the Hutt. For the first time summer studentships were set up for second and third year medical students. Six students took the opportunity to work here.

“We gave them glimpses of primary and secondary care, and our multidisciplinary team. They went out to Kokiri Marae and some of our outreach services and saw that primary care is wider than just General Practice.”

She says the students’ enthusiastic feedback bodes well for the hope that the Hutt Valley is on their radar as a place to work once they graduate.

Another initiative is funding ongoing education and offering other support for GPs with their Primex qualifications who must work for another two years as senior registrars. There are two enrolments on that programme.

“They’re doing some clinics in the hospital for half days, and multidisciplinary learning.

“Unashamedly, it’s about building our workforce. It can be quite a shift from being supported in training to being out on your own as a GP. Having finished their two years (with us), we’re hoping they’ll choose the Hutt Valley over Wellington or somewhere else and stay for the medium or long haul.”

But, she says, PHOs have also been working very hard to attract more GPs to the Hutt in a really competitive environment internationally. As at last month, there were 116 GPs working in the Hutt Valley (76.4 full-time equivalents). That’s a slight increase on the number late last year.

But Dr Fitzmaurice is blunt: “There are never going to be enough GPs in New Zealand to continue to do what we were doing.” Not only is our ageing population requiring more care, but the health workforce is ageing.

“For a whole lot of reasons – the obesity epidemic, health costs – our traditional model of medicine can’t continue to work well, so we need a new model.”

Health Minister Tony Ryall regularly speaks about the push to devolve secondary services to primary health care. One new model is a team approach to issues such as diabetes, obesity and respiratory illnesses, instead of a lack of co-ordination as patients are bounced between specialists.

“What does the ‘integrated family care centre’ that Tony Ryall talks about look like? That’s what we’re thinking about at the moment.”

Dr Fitzmaurice sees her role as “increasing the conversations” between primary and secondary care providers. She says such conversations have happened in the past “clinician to clinician” but now there needs to be a smooth, formalised and regular process underpinning that liaison.

A GP Clinical Reference Group has been established. GPs, and practice nurses and Hutt Hospital clinicians once a month get together to talk about making it easier for primary patients to access hospital services, such as a section of care within the hospital. The aim is to help them get better access for their patients to x-rays, to mental health, outpatient clinics – and vice versa.

“It’s an opportunity for primary care and secondary care clinicians to talk together about helping each other do things better for the benefit of the patients.”

A Long Term Conditions Think Tank, involving primary and secondary care doctors, nurses, allied health and social workers, management and the non-government organisation sector, is also meeting to discuss more effective, co-ordinated care options.

These aren’t simple issues. But the fact that Hutt Valley DHB is the first in the country to appoint a GP to report directly to its chief executive on improved primary/secondary liaison shows the problem is being taken seriously here, Dr Fitzmaurice says.

“I think if you improve communication between primary and secondary, we’re 90 per cent of the way there.”

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Finding it hard to get a GP in the Hutt Valley?

NZ Doctor notes that doctors and nurses in general practice average 50 years of age

At least 3000 patients are without a Doctor in the Hutt Valley

The Medical Council’s 2006 workforce survey, showing low GP coverage in areas such as Hutt Valley, where the DHB estimates 3000 people are not enrolled in a general practice.

Compared with the survey’s average of 73 full-time equivalent GPs per 100,000 people in 2006, Hutt Valley had only 60.

Hutt Valley DHB is working on a recruitment pilot scheme among other possible solutions to its GP shortage. That’s encouraging but the more immediate difficulty is a lack of locums that is depriving GPs of time off. Local MP Chris Hipkins also shows concern on this matter last year before election.

The current situation is still highly unsatisfactory, and as Winter approaches the difficulty continues for many Hutt Valley recent arrivals. Given the survey was undertaken in 2006, one wonders as to the current shortage, which I’m sure to hear in mainstream media as the winter deepens.